Rural nurse to nurse practitioner: an ad hoc process

Abstract

INTRODUCTION: Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rural nurse to NP in NZ. METHOD: A qualitative descriptive survey was sent to all NZ nurses with a rural address. Ninety-two questionnaires were returned, of which 21 respondents were working in a rural location and aiming to become an NP. Data analysis included description of demographic data and thematic analysis of open-ended question responses. FINDINGS: Four themes encompassed the experiences of the 21 potential NP candidates: uncertainty about opportunities for employment as an NP and legislative and funding barriers for NP practice; support or resistance from GPs and nurse colleagues, self-doubt, and the importance of mentoring; difficulties with the NP authorisation process; and meeting the NP competencies within the challenges imposed by rural location. CONCLUSION: At the systems level of workforce design, stronger linkages between policy development, investment, employment creation, funding streams, professional regulation and overall communication require attention. KEYWORDS: Rural health; nurse practitioners; workforce; health policy